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Local Weight-loss Surgery

People with clinically severe obesity may undergo one of two types of
weight-loss surgery performed at CayugaMedicalCenter.

Laparoscopic roux-en-y gastric bypass surgery reduces the size of the
stomach (limiting the amount of food that can be eaten) and redirects the flow
of food to a different part of the intestine, (where less food and fewer
nutrients are absorbed).

LAP-BAND surgery, in which a silicone band is placed around the top of the
stomach, significantly reduces the amount of food that can be consumed.

At the same time CayugaMedicalCenter
initiated the weight-loss surgery program, a local support group for
weight-loss surgery patients was established. This group has expanded into two
separate groups (one for each of the two different surgical procedures)
facilitated by their members. People who are considering weight-loss surgery
are required to attend a support group prior to surgery, both to meet people
who have had the procedure and to learn about various issues related to the
surgery.

Criteria for weight-loss surgery

As the effectiveness of this approach to treating severe obesity becomes
more widely known and accepted, a review of the criteria for surgery can inform
people's thinking as they consider the possibility of surgery.

There are several criteria a patient must meet to undergo weight-loss
surgery at CayugaMedicalCenter.
These criteria include the national (NIH) guidelines, as well as additional
recommendations of surgeons who are expert in weight-loss surgery. The goals are
patient safety first, followed by successful weight loss. The risk of
complications from surgery may differ depending on the individual. Since no
surgery is risk-free, we must do everything we possibly can to ensure a good
outcome for each and every patient.

Candidates for weight-loss surgery must either have a body-mass index (BMI)
greater than 40 or a BMI greater than 35, with a life-threatening or disabling
condition related to obesity, such as high blood pressure, cardiac illness, or
type 2 diabetes. Body mass index is a measure of
weight for height and it correlates with the amount of body fat a person is
carrying.

In addition, weight-loss surgery candidates:

• must have made several attempts at medical weight loss and failed in those
attempts • cannot have alcohol or drug abuse problems or untreated psychiatric
illness • must be non-smokers. • should be between the ages of 18 and 65 • must
have no absolute contraindication to major abdominal surgery • must have a
long-standing obesity problem • must understand the need for lifelong
post-surgical changes in lifestyle and dietary habits • have been fully
counseled on the risks and benefits of weight-loss surgery.

Patients who are extremely obese (i.e. BMI greater than 50 or weighing more
than 400 lbs.) or who have serious health issues may be poor candidates for
surgery initially. These patients may require medical interventions and
non-surgical weight-loss prior to being considered for surgery or may be
referred to a tertiary care center.

To learn more about weight-loss surgery, talk with your primary caregiver.
You can also get information on-line at www.obesityhelp.com and at the Web site
of the American Society for Bariatric Surgery at asbs.org.

To contact a local support group for additional information, call Surgical
Associates at (607) 273-3161. The office staff will put you in touch with one
of the support group leaders.

Weight-loss surgery at CayugaMedicalCenter is performed by Dr. John Mecenas, who did his fellowship training in minimally
invasive surgery and minimally invasive weight-loss surgery at NYUMedicalCenter. He is board
certified in general surgery and is in practice with Surgical Associates of Ithaca, where he can be
reached at (607) 273-3161.